PennLive reported the settlement involving Maple Farm Nursing Center and the family of a resident who was sexually assaulted by a fellow resident. The parties agreed to resolve the case for $6.75 million.  A jury had awarded $7.5 million to the family, and the home and its insurance carrier agreed to the lower settlement rather than appealing, said the report.

The suit was filed against the home and Glenn Hershey, who was convicted in 2014 with sexually assaulting the woman in the home in January 2013. He is serving a state prison sentence of 8-20 years.  The lawsuit claimed the home failed to ensure that Hershey, who was a registered sex offender, didn’t come in contact with the woman.

The Island Packett reported the investigation into an alleged sexual assault at a Hilton Head nursing home is continuing, according to Beaufort County Sheriff’s Office spokesperson Capt. Bob Bromage.  Bromage said previously a suspect in the assault has been identified as a nursing home employee.  The resident at the Life Care Center of Hilton Head informed a nurse she had been assaulted overnight. The center reported the incident to the sheriff’s office and the South Carolina Department of Health and Environmental Control.

DHEC said in an email it received an incident report of sexual assault from Life Care on May 2, 2018, according to Adrianna Bradley, DHEC spokesperson.  If you suspect someone has been treated improperly at a healthcare facility in South Carolina, complaints can be filed online, or by calling 803-545-4370, according to Bradley.

The Centers for Medicare & Medicaid Services recently rejected a proposal from Kansas to place a three-year lifetime cap on some adult Medicaid enrollees. Arizona, Utah, Maine and Wisconsin have also requested lifetime limits on Medicaid.  Since Medicaid began in 1965, no state has restricted how long beneficiaries could remain in the entitlement program.

 This was the first time the Trump administration has rejected a state’s Medicaid waiver request regarding who is eligible for the program.  CMS has approved work requirements for adults in four states —New Hampshire, Kentucky, Indiana and Arkansas.

All these states expanded Medicaid under the Affordable Care Act to cover everyone with incomes of more than 138% of the federal poverty level ($16,753 for an individual). The work requirements would apply only to adults added through that ACA expansion.

 

ABC6OnyourSide had an article about three nursing home employees indicted on charges that include involuntary manslaughter, forgery and gross patient neglect in the Jan. 7 death of 76-year-old Phyllis Campbell.  The three employees at Hilty Memorial Nursing Home in Pandora were on duty when a nursing home resident wandered off and died of hypothermia in January.

A state investigation found that Campbell left the facility around 12:30 a.m. Jan. 7 through a courtyard door equipped with an alarm. A device she wore apparently failed to alert workers. The low temperature that night was zero degrees.

 

 

The Journal-News reported on the rape of a nursing home resident by a mentally incompetent resident.  Gary Eugene Earls, who has limited mental capacity, was arrested by police after a incident at Close to Home.  Earls was indicted by a Butler County grand jury on two counts of rape in December.  Earls admitted to physically penetrating the 95-year-old woman during the early morning hours of Nov. 17. He said he went into the woman’s room and pulled down his pants. The woman was naked, Earls said.  The 95-year-old woman died just weeks after the incident. She suffered from dementia but was alert.

Prosecutors fought to keep control of the case to ensure Earls would not be placed in a facility where he could potentially assault another person. The issue surrounding what to do with Earls was “a black hole of the justice system,” Butler County Prosecutor Michael Gmoser said.

“(The judge) ultimately has to make a determination that the evidence established that he committed the acts to constitute the criminal offense,” Gmoser said. “It is also a serious offense and the public has an interest in respect to public safety … the state is asking for her to approve his commitment to a mental facility equipped to handle these type of offenders.”

The rapist was committed to a psychological facility, Summit Behavioral Health, a facility for mentally ill adults.  In addition to the cognitive problems, Earls has a history of alcohol and drug abuse.

 

 

Authorities are investigating the strangulation death of 75-year-old Rebecca Eudy, who was found April 5 at Open Fields Assisted Living in Tarboro.  Open Fields is an adult care facility, which houses the elderly and also some people with severe and persistent mental illness.

No arrests have been made yet.  Her death certificate says Eudy asphyxiated and suffered traumatic injuries to her neck.  Eudy was charged with assault in December after a fight with a 46-year-old man living at Open Fields who allegedly exposed himself to her.

Eudy’s daughter has filed a complaint with the state Department of Health and Human Services after learning that her mother’s death was being treated as a homicide.

A scabies outbreak at Longmeadow Nursing Care nursing home in south Arkansas spread throughout the facility and into the community after those in charge failed to act. According to a government report, management told nursing staff in some cases not to leave any documentation indicating they were treating residents for scabies, the Arkansas Democrat-Gazette reported. Residents with scabies weren’t isolated and proper procedures were neglected, causing employees to contract the bugs that spread outside the facility.  Scabies is a highly contagious skin condition caused by mites, according to the U.S. Library of Medicine.  The facility neglected to treat staff members who developed scabies, which eventually spread to their relatives, according to the report.

State regulators cited the facility in July for failing to properly address a smaller infestation affecting a few residents, just weeks before the condition struck every resident at Longmeadow. A nurse told inspectors the facility didn’t document the outbreak because of instructions from higher authorities.  The state Office of Long Term Care gave the violations the most severe rating.

Kelly Holland said her husband, Ralph, suffered from the scabies infestation.

“You could see where he had clawed them, trying to get to the itch,” said Holland.

She says the nursing staff tried to convince her that the itching was not caused by scabies.

“They kept saying ‘Oh it’s a side effect from one of your medications,’ … that was a lie … the whole thing was a lie,” said Holland.

“It was just torture for both me and for him,” said Holland.

Even though the facility has a way to track outbreaks like scabies, a worker told state inspectors higher’s up “Didn’t want us to document the residents had scabies on any of the paperwork, but that’s what we were treating them for.”

State records reveal that in some cases, nursing staff said they were told not to leave a paper trail and did not record whether its 28 residents received a topical cream prescribed by a physician during the December outbreak.

 

 

The Washington Post reported on a nursing home resident Rebecca Zeni who was “eaten alive” by scabies. Parasitic mites had burrowed under her skin, living and laying eggs all over her body. By the time she died, vesicles and thick crusts had formed on her skin. Her right hand had turned nearly black, and her fingers were about to fall off.  The scabies that infected Zeni’s body had become so severe that bacteria seeped into her bloodstream causing her wrongful death.  Zeni died June 2, 2015. An autopsy found that she died of Staphylococcus aureus septicemia due to Norwegian crusted scabies, a severe form of scabies that affects people with weak immune systems, such as the elderly.

Zeni’s death is now the subject of a lawsuit filed against PruittHealth, a for-profit company that owns dozens of nursing homes, including Shepherd Hills in LaFayette, Ga., where Zeni lived for five years until she died. Shepherd Hills, a nursing home that had multiple scabies outbreaks in recent years and a history of health violations, failed to follow policies and procedures to prevent the occurrence and spread of the highly contagious disease.  Instead of providing the care that Zeni desperately needed, the lawsuit alleges that the nursing home allowed her to die an agonizing death.

A lawyer for the company, Jeffrey Braintwain, argues that, among other defenses, injuries may have been caused by people PruittHealth cannot control. This includes Puryear and Zeni herself.  The nursing home is blaming the resident!!!

Federal health inspection records paint a troubling picture of the company, which describes itself as the “regional leader” of providing long-term health care to the elderly in the southeast. In August 2013, according to the Georgia Department of Public Health, 10 residents and 10 staff members were affected by scabies. In October 2014, the home’s internal infection log shows, at least six patients were affected. In May 2015, according to the Department of Public Health, 20 residents and another 15 staff members were affected.

Many PruittHealth-owned facilities have similarly dismal records. Nineteen other facilities in Georgia, seven in South Carolina and one in North Carolina received one- and two-star ratings from Medicare.  Of the 56 nursing homes owned by Pruitt in Georgia, nearly half (46%) are rated “below” or “much below average.” In total, Pruitt’s one and two-star facilities collected $221 million from Medicaid in 2016 and 2017.

Zeni’s death raises crucial — and familiar — questions about for-profit nursing homes that have long been accused of sacrificing patient care to minimize costs and maximize bottom lines. Nursing homes owned by big corporations and private investment firms consistently performed poorly in terms of quality of care and are more likely than nonprofit and government facilities to be cited for “serious deficiencies” that harm residents, according to 2011 and 2016 reports by the Government Accountability Office. Staffing levels are usually lower, meaning trained nurses spend less time with residents each day.

Human scabies results when an adult female human itch mite burrows into the top layer of your skin, otherwise known as the epidermis. There the mite can hang out, poop, and lay eggs. The eggs can then produce new mites, leading to more and more mites in your skin. Each mite can live a couple months in your skin. That is the Circle of Mites.

Image result for scabies mites picture

When the infestation is ignored, thousands of mites may be reproduced.  Norwegian or crusted scabies tends to occur when your immune system is weak, allowing the mites to reproduce more. With so many mites, the skin forms crusts that are thick, gray, and crumbly.

The mites are so small that you can’t see them. A simple view from a microscope will allow caregivers to figure out if a resident has scabies.  Tthey can be passed unknowingly from person-to-person via skin-to-skin contact. Transmission only occurs via human-to-human contact.  The contact has to be prolonged and intimate.   This should not happen in a nursing home since caregivers are required 1) to wear sterile gloves before caring for a resident, and 2) wash their hands before caring for a resident.

The mite can survive on objects such as a blanket, other bedding, clothes, and furniture for about 3 to 4 days, so you could catch scabies from such items. Therefore, make sure you thoroughly wash (using the hottest temperature possible) or seal in a bag for at least a week any object that may be affected.

Symptoms can take anywhere from a few days to 4 to 6 weeks to appear. The itching tends to be worse at night and can keep you awake. The classic appearance of the rash is a line of little bumps, as described by the American Academy of Dermatology. The rash can become scaly and look a bit like eczema.

Image result for norwegian scabies crusted

Scratching can convert the rashes into sores. Sores can lead to infection. Infections can potentially lead to death, especially if you are in a weakened condition.  An elderly person’s immune system is weaker and won’t attack the mite as vigorously. If not treated, the mites will multiply indefinitely. A patient can have thousands of mites in his or her body. They form crust on the skin. The crust sheds, carrying mites and eggs with it. The outbreak spreads.  Tomorrow, we will discuss a recent nursing home case involving scabies.

 

Fox40 had an article about for-profit nursing home chains in California that illegally prioritizes some patients over others based on how much of a payout insurance will pay the individual nursing home for each.  As soon as a resident goes from Medicare (where reimbursements are high) to Medicaid (where the nursing home gets a flat fee), the chain tries to get rid of them.  These chains discharge residents without proper notice or a legal reason.  It’s called patient dumping and it’s illegal.  Under California law, nursing homes need to notify patients 30 days before they’re let go.

“What’s happened is the money’s gotten the best of the providers,” Tony Chicotel, a spokesman with the California Advocates for Nursing Home Reform,  said. He urges consumers to follow the money. “Medicare pays a significantly higher rate per day for nursing home care than [MediCal] or even private pay dollars do,” he said.  According to Chicotel, the problem is Medicare only provides a few months’ worth of nursing home care to patients. When that runs out, he says some nursing homes rush to fill her bed with someone else on Medicare.  “The more you occupy your beds with Medicare residents, the more money you’re going to make. Sometimes three or four times as much.”

He’s working on a class action lawsuit filed against SavaSeniorCare, a national for-profit billion dollar chain.  SavaSeniorCare has over 200 facilities nationwide including 4 in South Carolina.  SavaSeniorCare is also part of a False Claims Act case in Tennessee.  See Hayward doc 59.

“It’s a very widespread problem. It involves dozens of nursing home chains in California, hundreds of individual nursing homes. It’s a problem that’s affected northern, central, southern California. We hear about it everywhere,” Chicotel said.

A representative from Mission Carmichael, a care facility owned and operated by Sava, did respond to the lawsuit, saying only that they’re “aware of the case” and “cannot comment about the specifics”